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Care Information (care + information)
Kinds of Care Information Selected AbstractsAn algorithm to identify antidepressant users with a diagnosis of depression from prescription dataPHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 1 2009Helga Gardarsdottir PharmD Abstract Purpose Antidepressants are used for many indications besides depression. This makes investigating depression treatment outcomes in prescription databases problematic when the indication is unknown. The aim of our study is to develop an algorithm to identify antidepressant drug users from prescription data that suffer from depression. Methods Data for deriving the algorithm were obtained from the Second Dutch National Survey of General Practice, carried out in 2001 by The Netherlands Institute for Health Services Research (NIVEL), and for validation the Integrated Primary Care Information (IPCI) database was used. Both sets included adults receiving their first antidepressant drug in 2001 (n,=,1855 and 3321, respectively). The outcome was a registered diagnosis of depression. Covariates investigated for developing the algorithm were patient and prescribing characteristics, and co-medication. Results The predictive algorithm included age, SSRI prescribed on the index date, prescribed dose, general practitioner as prescriber and the number of antidepressant prescriptions prescribed plus medication for treating acid related disorders, laxatives, cardiac therapy or hypnotics/sedatives prescribed in the 6 months prior to index date. The probability that the algorithm correctly identified an antidepressant drug user as having a depression diagnosis was 79% with a sensitivity of 79.6% and a specificity of 66.9%. Conclusion In conclusion, we developed and validated an algorithm that can be used to compose cohorts of patients treated with antidepressants for depression from prescription databases. Copyright © 2008 John Wiley & Sons, Ltd. [source] Adverse drug reaction-related hospitalisations: a population-based cohort studyPHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2008Cornelis S. van der Hooft MD Abstract Purpose To evaluate the extent, characteristics and determinants of adverse drug reaction (ADR)-related hospitalisations on a population-based level in 2003. Methods We performed a cohort study in the Integrated Primary Care Information (IPCI) database, a general practitioners (GPs) research database with longitudinal data from electronic patient records of a group of 150 GP throughout the Netherlands. Hospital discharge letters and patient records were reviewed to evaluate ADR-related hospitalisations applying WHO causality criteria. The prevalence of ADR-related hospitalisations per total admissions and the incidence per drug group were calculated. Avoidability and seriousness of the ADRs causing admission were assessed applying the algorithm from Hallas. Results We identified 3515 hospital admissions, 1277 elective and 2238 acute. Of the acute admissions, 115 were caused by an ADR giving a prevalence of 5.1% (95% confidence intervals (CI): 4.3,6.1%). The prevalence of ADR-related acute admissions increased with age up to 9.8% (95%CI: 7.5,12.7) for persons >75 years. The ADRs that most frequently caused hospitalisations were gastro-intestinal bleeding with anti-thrombotics, bradycardia/hypotension with cardiovascular drugs and neutropenic fever with cytostatics. The incidence rate of ADR-related hospitalisations per drug group was highest for anti-thrombotics and anti-infectives and was relatively low for cardiovascular drugs. Fatality as a direct consequence of the ADR-related admission was 0.31%. In elderly patients 40% of the ADRs causing hospitalisation were judged to be avoidable. Conclusions The extent and potential avoidability of ADR-related hospitalisations is still substantial, especially in elderly patients. Measures need to be put into place to reduce the burden of ADRs. Copyright © 2008 John Wiley & Sons, Ltd. [source] Ensuring Quality Information for Patients: development and preliminary validation of a new instrument to improve the quality of written health care informationHEALTH EXPECTATIONS, Issue 2 2004Beki Moult BA(Hons) MSc Abstract Background, Despite the recent focus on improving the quality of patient information, there is no rigorous method of assessing quality of written patient information that is applicable to all information types and that prescribes the action that is required following evaluation. Objective, The aims of this project were to develop a practical measure of the presentation quality for all types of written health care information and to provide preliminary validity and reliability of the measure in a paediatric setting. Methods, The Ensuring Quality Information for Patients (EQIP) tool was developed through a process of item generation, testing for concurrent validity, inter-rater reliability and utility. Patient information managers and health care professionals tested EQIP in three annual audits of health care leaflets produced by a children's hospital. Results, The final tool comprised 20 items. Kendall's , B rank correlation between EQIP and DISCERN was 0.56 (P = 0.001). There was strong agreement between intuitive rating and the EQIP score (Kendall's , B = 0.78, P = 0.009). Internal consistency using Cronbach's , was 0.80. There was good agreement between pairs of raters (mean , = 0.60; SD = 0.18) with no differences based on types of leaflets. Audits showed significant improvement in the number of leaflets achieving a higher quality EQIP rating over a 3-year period. Conclusions, EQIP demonstrated good preliminary validity, reliability and utility when used by patient information managers and healthcare professionals for a wide variety of written health care information. EQIP uniquely identifies actions to be taken as a result of the quality assessment. Use of EQIP improved the quality of written health care information in a children's hospital. Wider evaluation of EQIP with written information for other populations and settings is recommended. [source] Post-discharge health care needs of patients after lung cancer resectionJOURNAL OF CLINICAL NURSING, Issue 17-18 2010Kwua-Yun Wang Aims and objective., To determine the health care needs of patients after surgical resection of lung cancer at discharge and evaluate the significance of factors associated with such needs. Background., Other studies have found that symptom distress level, social supports and health beliefs are associated with health care needs. Design., Sixty-two participants were recruited from a thoracic surgery clinic at a medical centre in Taipei from July,December 2005. Data related to demographic variables, disease characteristics, functional status, symptom distress and social support were collected. Methods., The patients were administered the Karnofsky Performance Scale, the Symptom Distress Scale,Chinese Modified Form, the Social Support Scale (adapted from the Interpersonal Support Evaluation List), the Health Needs Scale and self-reported rating scales for pain. Data were analysed using Pearson's correlation coefficients and linear regression models. Results., Pulmonary function was found to be correlated with the level of need for health care information and physiological care. Self-perceived symptom distress and degree of distress were also correlated with levels of need for information, physiological care and psychosocial care. The level of pain was found to be correlated with the level of need for health care information and physiological care. After controlling for pain level, multivariate analysis revealed that self-perceived symptom severity (p = 0·032) and degree of distress (p = 0·043) were modestly correlated with the need for health care. Conclusions., Pulmonary function, self-perceived symptom distress, degree of distress and level of pain were correlated with the level of need for health care information and physiological care. Self-perceived symptom severity and degree of distress were independent predictors of health care needs. Relevance to clinical practice., Administration of relevant questionnaires to assess postoperative symptom distress may be necessary for optimal disease management. [source] Situating Internet Use: Information-Seeking Among Young Women with Breast CancerJOURNAL OF COMPUTER-MEDIATED COMMUNICATION, Issue 3 2010Ellen Balka In recent years considerable attention has been focused on the potential of the Internet as a means of health information delivery that can meet varied health information needs and empower patients. In this article, we explore utilization of the Internet as a means of health information consumption amongst young women with breast cancer who were known Internet users. Focusing on a population known to be competent at using the Internet allowed us to eliminate the digital divide as a possible explanation for limited use of the Internet for health information-seeking. Ultimately, this allowed us to demonstrate that even in this Internet savvy population, the Internet is not necessarily an unproblematic means of disseminating health care information, and to demonstrate that the huge amount of health care information available does not automatically mean that information is useful to those who seek it, or even particularly easy to find. Results from our qualitative study suggest that young women with breast cancer sought information about their illness in order to make a health related decision, to learn what would come next, or to pursue social support. Our respondents reported that the Internet was one source of many that they consulted when seeking information about their illness, and it was not the most trusted or most utilized source of information this population sought. [source] Managing discontinuity in academic medical centers: Strategies for a safe and effective resident sign-outJOURNAL OF HOSPITAL MEDICINE, Issue 4 2006Arpana R. Vidyarthi MD Abstract BACKGROUND Restrictions in the hours residents can be on duty have resulted in increased sign-outs, that is, transfer of patient care information and responsibility from one physician to a cross-coverage physician, leading to discontinuity in patient care. This sign-out process, which occurs primarily in the inpatient setting, traditionally has been informal, unstructured, and idiosyncratic. Although studies show that discontinuity may be harmful to patients, this is little data to assist residency programs in redesigning systems to improve sign-out and manage the discontinuity. PURPOSE This article reviews the relevant medical literature, current practices in non,health professions in managing discontinuity, and summarizes the existing practice and experiences at 3 academic internal medicine hospitalist-based programs. CONCLUSIONS We provide recommendations and strategies for best practices to design safe and effective sign-out systems for residents that may also be useful to hospitalists working in academic and community settings. Journal of Hospital Medicine 2006;1:257,266. © 2006 Society of Hospital Medicine. [source] Expatriates in High,UV Index and Tropical Countries: Sun Exposure and Protection Behavior in 9,416 French AdultsJOURNAL OF TRAVEL MEDICINE, Issue 2 2007Khaled Ezzedine MD Background Overexposure to sunlight during long stays in tropical countries can reveal short- and long-term harmful effects on the skin of Caucasian residents, especially for fair-skinned subjects. The aim of this study was to describe sun exposure and sun protection behaviors during lifetime among French adults who declared having experienced at least one expatriation period in tropical or high,sun index areas for a duration of more than three consecutive months. Methods A self-reported questionnaire on sun exposure behavior was addressed two times, in 1997 and 2001, to the 12,741 French adult volunteers enrolled in the SU.VI.MAX cohort. A total of 8,084 subjects answered to the first survey and 1,332 additional responders answered to the second. Among the 9,416 individuals, 1,594 (652 women and 942 men) corresponded to expatriates and the remaining 7,822 to nonexpatriates (4,972 women and 2,850 men). A descriptive analysis of sun exposure and sun protection behaviors during lifetime of expatriates and nonexpatriates was performed by gender. Results Among women, 39% of expatriates belonged to the 50 to 60 class of age at inclusion, versus 33% in nonexpatriates (72 and 55% in men, respectively). In women, expatriates declared more frequently having during lifetime exposed voluntarily their skin to the sun, practiced tanning between 11 a.m. and 4 p.m., less gradually exposed their skin, experienced intensive sun exposure, and exposed their skin during nautical sports and practiced naturism. In men, expatriates declared more frequently having experienced intensive sun exposure and exposed their skin during outdoor occupations and during nautical and mountain sports. Conclusions Although expatriates are aware of travel health advices concerning the countries where they planned to stay, they are usually poorly informed about sun exposure risk factors. Such individuals who planned to expatriate in countries with a high ultraviolet index should benefit from a visit to a travel clinic including specific health care information for risk related to sun exposure, ie, skin cancers and photoaging. [source] Modifications of Graduate Public/ Community Health Nursing Internships to Facilitate Compliance with Institutional Review Board and Health Insurance Portability and Accountability Act (HIPAA) RegulationsPUBLIC HEALTH NURSING, Issue 2 2005Gwendolyn F. Foss ABSTRACT, This paper describes the changes that were made to a two-semester graduate internship course to facilitate student compliance with Institutional Review Board (IRB) and agency requirements for compliance with the Privacy Rule of the Health Insurance Portability and Accountability Act (HIPAA). Students now spend the first semester of the internship developing collaborative relationships with the agency and conceptualizing, planning, and developing all aspects of the project, including preparing materials for an IRB review. A series of workshops about the IRB process, the Privacy Rule of HIPAA, and on-line resources have been developed. A password-protected web site and other resources were developed for preceptors. The result of the changes has been primarily positive. By having to conceptualize and develop the entire project at the beginning, students demonstrate a better understanding of program development and evaluation. Their writing has markedly improved. Preceptors like the course revisions, the convenience of on-line resources, and the enhanced course focus on the protection of health care information and of potential participants in health education programs or program evaluation projects. [source] Doctors in a Wired World: Can Professionalism Survive Connectivity?THE MILBANK QUARTERLY, Issue 3 2002David Blumenthal The Information Revolution Has Raised Myriad questions about how the health care system will function in the future (Gingrich and Magaziner 2000; National Research Council 2000). The consensus seems to be that new information technologies will significantly affect almost every aspect of health care, from the way that employers and individuals purchase health insurance to the way that doctors and patients provide and receive care (National Research Council 2000). Although peer-reviewed evidence to support these predictions is scarce, the available data suggest that the major health care actors are actively experimenting with the new capabilities to exchange information. A February 2002 survey by Harris Interactive (www.Harrisinteractive.com) found that 137 million Americans were users of the Internet and the World Wide Web and 110 million reported going on-line at least three times a month to look for health care information (Landro 2002). An earlier survey by the Pew Charitable Trusts reported that of those Americans who used the Internet for health care purposes, 92 percent found the information useful. The information revolution has the potential to reduce the asymmetry of information between patients and doctors and thereby to undermine a central pillar of physicians' claim to professional status: the possession of distinctive competence based on technical know-how selflessly applied and collectively monitored. A close analysis of the information revolution's likely effects suggests that for some patients with some conditions, their access to more and better information will indeed reduce the magic, mystery, and power of the medical profession. However, the information revolution also offers opportunities for physicians to bolster the cognitive and moral bases of professionalism. To seize those opportunities, physicians must master new roles and skills and avoid unacceptable conflicts of interest. [source] | ||||||||||